How do I tell my psychiatrist I disagree with his diagnosis?
Last year my psychiatrist diagnosed me with opiod dependence and Bipolar II. He has since tried over 30 different meds on me, usually in combinations of 4-5. Right now, for example, I am on Trazadone, Lithium, Lamictal, Neurontin, Suboxone and a pill that helps with one of the side effects of Suboxone.
I have always been wary of this Bipolar diagnosis, and recently, after reading the diagnosis criteria from the DSM-IVTR and another instituations 24 point criteria, I believe I have ADHD.
I want to tell my psychiatrist this when I see him tomorrow, but honestly, he sees me as a drug-seeking addict who just wants to diagnose myself and have him write prescription for what I want. This isn't the case. I actually would prefer to cut down what I am on or even go homeopathic.
The main problem is that because I am an addict, many psychiatrists will not even treat me. And the ones who will make you take the Suboxone maintainence and they do not accept insurance for it. Every one that I have talked to wants at least $250 for the initial consultation and $150 a month there after in cash upfront, no insurance or billing. My current doctor only has me pay a $13 copay when I see him each month, and actually, I've met my deductible, so for the past few months it has been free.
How can I broach this subject without him brushing me off? Any psychiatrists out there who can tell me what they would think if I said this to them?
2008-11-30T21:14:33Z
Well, if I do have ADHD, I know that Ritalin and Adderall are addictive...I've tried to abuse Adderall in the past but it didn't do much for me. I was thinking more Concerta or Statera.
Actually, like I said in the post, I would love to just do it with supplements and natural medicine. I'd just like to get a correct diagnosis.
2008-11-30T21:32:29Z
My doctor is licensed and is an addictionologist as well.
painisbeauty7262008-11-30T23:43:13Z
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your phsychiatrist is there to help YOU. YOU hired him. he has to listen to you and consider your opinions, or else you would go somewhere else. he may not think you are right but he is obligated to hear you out because you pay him to.
Well I am actually an addictions therpist, but I did do mental health therapy for awhile. I dont know what your symptoms are, but you dont have to meet every single on of those criteria in the DSM IV to have bipolar disorder. I actully have a form of bipolar disorder that they call bipolar 2, and it is a much milder form, I have anxiety some times and sometimes I feel some depression. The last place you should be getting suboxone is from a psychoatrist. You need to be getting it off of a certified doctor the is liscened under the DATA 2000 law. Alot of the physicians that are certified sompletely rip you off, but there are some great ones out there. I am a former addict, and I used suboxone to detox, and I used it for maintence for a little while, but when I took it, it was brand new, and insurances didnt pay for it, but now they all do, so you need to go on Rekkitt Bankisters main website for buprinorphine, which is Suboxone or Subutex, and type in where you live and they will give you an entire list of doctors in your area that can prescribe it for you. Most doctors will take the insurance. As far as the other meds your on, the lamictal is a mood stabilizer, so you definately need that for the bipolar issue, and the Trazadone is to help you sleep, so if your having trouble falling asleep at night then thats why he gave you that. What you will have to understand is when you are an addict then most doctors are going to treat you like one, because they have to be careful. I am a recovering addict, and I work in a drug rehab, and counsel addicts all day long, but I can tell when they are drug seeking, and manipukating our psychiatrist. No patient should ever tell the psychioatrist what they want to take, or what they think they need, or what they think their diagnosis is. The only thing you can really do is get a second opinion from another therapist, and see if they give you the same diagnosis. But ADHD, means you are hyper all the time, and constantly cannot sit still or concentrate. You had to tell your psychiatrist that you were depressed some of the time or there is no way he would of told you that you were bipolar, so when you are feeling those times like you cant sit still, and you feel like you have crazy anxiety that is when you are in a manic mood, and when you go down, and feel like you could sleep alot, and get a little depressed that is when you are in the depresive phase, which is bipolar disorder. It doesnt have to be to the extreme that the DSM IV goes to. That is why they dont suggest you read it unless you are a mental health proffesional because you may not understand it.
I hate to say this but many of them are quacks that are out for the bucks, although you only had to pay him $13.00 he's getting a kickback on the drugs and insurance. I'm not saying this guy is good or bad because I don't know him but if your not happy with him you should change. You need to get off the drug treadmill though and get yourself some real help that you can see some positive results from. Bipolar disorder is a serious issue as is drug abuse, so you do need care, but you need proper care. Make sure who ever you see has your best interest at heart.
I would just ask if he is sure about the bipolar diagnosis, because none of the drugs are helping you. See if he can go thru the DSM with you for both diagnoses, and ask him why he thinks it is bipolar you have. Do you have depression? Depression is not a symptom of ADHD. I have bipolar disorder, and have not been able to get meds to help me with the depression, so I do take amphetamine salts so I can be a bit more revved up and get a few things done in spite of horrific depression. My doc says that this med does help some people with depression, so it wouldn't be out of line to try this approach. However, I have no history of drug abuse and have seen this doc for 7 years, so she knows me and knows I am honest with her. Sometimes, you just have to build a rapport with the doc for awhile and build trust.
I think you should just tell him straight out, i have the same issue as you, ive been diagnosed with Bipolar ll but dont think thats the case. If he brushes it off i think its time for you to find a new psychiatrist. Even though most of them are expensive you'll find that paying that money will be worth getting a proper answer and results. Good luck